Development of the WHO STARS: A Tool for the Systematic Assessment of Rehabilitation Situation.

Abstract Objective: To present the development process of the World Health Organization Systematic Assessment of Rehabilitation Situation (STARS). Design: A conceptualization phase to establish its objective and identify the content for comprehensively describing rehabilitation in countries, a second phase to draft and a third phase to refine the tool. Reviews of existing health system assessment (HSA) tools used in other areas of health as well as expert consultations occurred. Setting: The WHO initiated development of STARS as there is currently no comprehensive HSA tool for rehabilitation that supports stakeholders describing their country situation and identifying priority actions. Participants: The WHO rehabilitation team, experts representing rehabilitation professions and from all WHO regions, and government and rehabilitation consumer groups. Interventions: Conceptualizing, drafting and consultation and review of the WHO STARS. Main outcomes measures: Development of a tool that is comprehensive, able to support countries to describe rehabilitation and identify priorities. Results: STARS was developed in a participatory process, utilizes a logic model to structure the 50 components of rehabilitation selected for assessment, it assesses both capacity and performance. Conclusions: STARS is the first HSA shaped to rehabilitation, has been developed by WHO in a participatory process based on several expert consultations and has the potential to meaningfully support governments better understand the status of rehabilitation in their countries, define priorities for action to strengthen rehabilitation, and facilitate the monitoring of system level changes. Moreover, STARS information can be used in research to support evidence-informed policy and programs.